Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
Langenbeck's Archives of Surgery
Erschienen in: Langenbeck's Archives of Surgery 2/2011

01.02.2011 | Review Article

Chronic pancreatitis: modern surgical management

verfasst von: Kai Bachmann, Jakob R. Izbicki, Emre F. Yekebas

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 2/2011

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Chronic pancreatitis (CP) is a disease with enormous social and personal impact. It is most commonly caused by the abuse of alcohol combined with nicotine. CP is usually characterised by an inflammatory mass located in the pancreatic head. Its natural course is characterised by persistent or recurrent painful attacks as well as progressive loss of pancreatic function due to fibrosis of the parenchyma with consecutive endocrine and exocrine insufficiency.

Conclusions

The only success parameter of any treatment is the effective long-lasting pain relief and improvement in the quality of life. The surgical armamentarium includes simple drainage procedures, resections of different extents or a combination of both. Duodenum-preserving resection of the pancreas offers the best short-term outcome according to trials conducted so far. It has the benefit of combining the highest safety with the highest efficiency. Additionally, the extent of the operation can be adapted to the morphology of the individual patient.
Literatur
1.
Adler DG, Lichtenstein D, Baron TH, Davila R, Egan JV, Gan SL, Qureshi WA, Rajan E, Shen B, Zuckerman MJ, Lee KK, VanGuilder T, Fanelli RD (2006) The role of endoscopy in patients with chronic pancreatitis. Gastrointest Endosc 63(7):933–937CrossRefPubMed
2.
Ammann RW (1997) A clinically based classification system for alcoholic chronic pancreatitis: summary of an international workshop on chronic pancreatitis. Pancreas 14:215–221CrossRefPubMed
3.
Ammann RW, Akovbiantz A, Largiader F, Schueler G (1984) Course and outcome of chronic pancreatitis. Longitudinal study of a mixed medical–surgical series of 245 patients. Gastroenterology 86:820–888PubMed
4.
Ammann RW, Mullhaupt B (2007) Do the diagnostic criteria differ between alcoholic and nonalcoholic chronic pancreatitis? J Gastroenterol 42(Suppl 17):118–126CrossRefPubMed
5.
Bachmann K, Mann O, Izbicki JR, Strate T (2008) Chronic pancreatitis—a surgeons' view. Med Sci Monit 14(11):RA198–RA205PubMed
6.
Beger HG, Buechler M (1990) Duodenum preserving resection of the head of the pancreas in chronic pancreatitis with inflammatory mass in the head. World J Surg 14:83–87CrossRefPubMed
7.
Beger HG, Witte C, Krautzberger W, Bittner R (1980) Experiences with duodenum-sparing pancreas head resection in chronic pancreatitis. Chirurg 51:303–307PubMed
8.
Bernades P, Baetz A, Levy P, Belghiti J, Menu Y, Fekete F (1992) Splenic and portal venous obstruction in chronic pancreatitis. A prospective longitudinal study of a medical–surgical series of 266 patients. Dig Dis Sci 37:340–346CrossRefPubMed
9.
Bloechle C, Busch C, Tesch C, Nicolas V, Binmoeller KF, Soehendra N, Izbicki JR (1997) Prospective randomized study of drainage and resection on non-occlusive segmental portal hypertension in chronic pancreatitis. Br J Surg 84:477–482CrossRefPubMed
10.
Bockhorn M, Gebauer F, Bogoevski D, Molmenti E, Cataldegirmen G, Vashist YK, Yekebas EF, Izbicki JR, Mann O (2010) Chronic pancreatitis complicated by cavernous transformation of the portal vein: contraindication to surgery? Surgery. doi:10.​1016/​j.​surg.​2010.​06.​011
11.
Born P, Rosch T, Bruhl K, Ulm K, Sandschin W, Frimberger E, Allescher H, Classen M (1998) Long-term results of endoscopic treatment of biliary duct obstruction due to pancreatic disease. Hepatogastroenterology 45(21):833–839PubMed
12.
Bracher GA, Manocha AP, DeBanto JR, Gates LK Jr, Slivka A, Whitcomb DC, Bleau BL, Ulrich CD, Martin SP (1999) Endoscopic pancreatic duct stenting to treat pancreatic ascites. Gastrointest Endosc 49(6):710–715CrossRefPubMed
13.
Bradley EL (1987) Long-term results of pancreatojejunostomy in patients with chronic pancreatitis. Am J Surg 153:207–213CrossRefPubMed
14.
Buchler MW, Friess H, Muller MW, Wheatley AM, Beger HG (1995) Randomized trial of duodenum-preserving pancreatic head resection versus pylorus-preserving Whipple in chronic pancreatitis. Am J Surg 169(1):65–69CrossRefPubMed
15.
Buechler M, Friess H, Isenmann R, Bittner R, Beger HG (1993) Duodenum-preserving resection of the head of the pancreas: the Ulm experience. In: Beger HG, Buechler M, Malfertheimer P (eds) Standards in pancreatic surgery. Springer, Berlin, pp 436–449
16.
Buechler MW, Friess H, Bittner R, Roscher R, Krautzberger W, Mueller MW, Malfertheiner P, Beger HG (1997) Duodenum-preserving pancreatic head resection: long-term results. J Gastrointest Surg 1:13–19CrossRef
17.
Cahen DL, Gouma DJ, Nio Y, Rauws EA, Boermeester MA, Busch OR, Stoker J, Lameris JS, Dijkgraaf MG, Huibregtse K, Bruno MJ (2007) Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med 356(7):676–684CrossRefPubMed
18.
Cataldegirmen G, Bogoevski D, Mann O, Kaifi JT, Izbicki JR, Yekebas EF (2008) Late morbidity after duodenum-preserving pancreatic head resection with bile duct reinsertion into the resection cavity. Br J Surg 95(4):447–452CrossRefPubMed
19.
Chari ST (2007) Chronic pancreatitis: classification, relationship to acute pancreatitis, and early diagnosis. J Gastroenterol 42(Suppl 17):58–59CrossRefPubMed
20.
Chebli JM, Gaburri PD, De Souza AF, Ornellas AT, Martins Junior EV, Chebli LA, Felga GE, Pinto JR (2004) Internal pancreatic fistulas: proposal of a management algorithm based on a case series analysis. J Clin Gastroenterol 38(9):795–800CrossRefPubMed
21.
da Cunha JE, Machado M, Bacchella T, Penteado S, Mott CB, Jukemura J, Pinotti HW (1995) Surgical treatment of pancreatic ascites and pancreatic pleural effusions. Hepatogastroenterology 42(5):748–751PubMed
22.
Diener MK, Rahbari NN, Fischer L, Antes G, Buchler MW, Seiler CM (2008) Duodenum-preserving pancreatic head resection versus pancreatoduodenectomy for surgical treatment of chronic pancreatitis: a systematic review and meta-analysis. Ann Surg 247(6):950–961CrossRefPubMed
23.
Duffy JP, Delano MJ, Reber HA (2002) Pancreatic surgery. Curr Opin Gastroenterol 18(5):568–573CrossRefPubMed
24.
Eckhauser F, Raper SE, Knol JA, Mulholland MW (1991) Surgical management of pancreatic pseudocysts, pancreatic ascites, and pancreaticopleural fistulas. Pancreas 6(Suppl 1):S66–S75PubMed
25.
Farkas G, Leindler L, Daroczi M, Farkas G Jr (2008) Long-term follow-up after organ-preserving pancreatic head resection in patients with chronic pancreatitis. J Gastrointest Surg 12(2):308–312CrossRefPubMed
26.
Farkas G, Leindler L, Daroczi M, Farkas G Jr (2006) Prospective randomised comparison of organ-preserving pancreatic head resection with pylorus-preserving pancreaticoduodenectomy. Langenbecks Arch Surg 391(4):338–342CrossRefPubMed
27.
Frey CF, Amikura K (1994) Local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy in the management of patients with chronic pancreatitis. Ann Surg 220:492–507CrossRefPubMed
28.
Frey CF, Smith GJ (1987) Description and rationale of a new operation for chronic pancreatitis. Pancreas 2:701–707CrossRefPubMed
29.
Frey CF, Suzuki M, Isaji S (1990) Treatment of chronic pancreatitis complicated by obstruction of the common bile duct or duodenum. World J Surg 14:59–69CrossRefPubMed
30.
Gloor B, Friess H, Uhl W, Buchler MW (2001) A modified technique of the Beger and Frey procedure in patients with chronic pancreatitis. Dig Surg 18:21–25CrossRefPubMed
31.
Gomez-Cerezo J, Barbado CA, Suarez I, Soto A, Rios JJ, Vazquez JJ (2003) Pancreatic ascites: study of therapeutic options by analysis of case reports and case series between the years 1975 and 2000. Am J Gastroenterol 98(3):568–577PubMed
32.
Howard TJ, Browne JS, Zyromski NJ, Lavu H, Baker MS, Shen C, Madura JA (2008) Mechanisms of primary operative failure and results of remedial operation in patients with chronic pancreatitis. J Gastrointest Surg 12(12):2087–2095CrossRefPubMed
33.
Huizinga WK, Thomson SR, Spitaels JM, Simjee AE (1992) Chronic pancreatitis with biliary obstruction. Ann R Coll Surg Engl 74(2):119–123PubMed
34.
Ihse I, Borch K, Larsson J (1990) Chronic pancreatitis: results of operations for relief of pain. World J Surg 14(1):53–58CrossRefPubMed
35.
Izbicki JR, Bloechle C, Broering DC, Knoefel WT, Kuechler T, Broelsch CE (1998) Extended drainage versus resection in surgery for chronic pancreatitis—prospective randomized trial comparing the longitudinal pancreaticojejunostomy combined with local pancreatic head excision with the pylorus preserving pancreatoduodenectomy. Ann Surg 228:771–779CrossRefPubMed
36.
Izbicki JR, Bloechle C, Broering DC, Kuechler T, Broelsch CE (1998) Longitudinal V-shaped excision of the ventral pancreas for small duct disease in severe chronic pancreatitis. Ann Surg 227:213–219CrossRefPubMed
37.
Izbicki JR, Bloechle C, Knoefel WT, Binmoeller KF, Soehendra N, Broelsch CE (1997) Drainage versus Resektion in der chirurgischen Therapie der chronischen Kopfpankreatitis: eine randomisierte Studie. Chirurg 68:369–377CrossRefPubMed
38.
Izbicki JR, Bloechle C, Knoefel WT, Kuechler T, Binmoeller KF, Broelsch CE (1995) Duodenum preserving resections of the head of the pancreas in chronic pancreatitis—a prospective randomized trial. Ann Surg 221:350–358CrossRefPubMed
39.
Izbicki JR, Bloechle C, Knoefel WT, Rogiers X, Kuechler T (1999) Surgical treatment of chronic pancreatitis and quality of life after operation. Surg Clin North Am 79:913–944CrossRefPubMed
40.
Izbicki JR, Bloechle C, Knoefel WT, Wilker DK, Dornschneider G, Seifert H, Passlick B, Rogiers X, Busch C, Broelsch CE (1994) Complications of adjacent organs in chronic pancreatitis managed by duodenum-preserving resection of the head of the pancreas. Br J Surg 81:1351–1355CrossRefPubMed
41.
Izbicki JR, Wilker DK, Waldner H, Rueff FL, Schweiberer L (1989) Thoracic manifestations of internal pancreatic fistulas: report of five cases. Am J Gastroenterol 84(3):265–271PubMed
42.
Izbicki JR, Yekebas EF, Strate T, Eisenberger CF, Hosch SB, Steffani K, Knoefel WT (2002) Extrahepatic portal hypertension in chronic pancreatitis: an old problem revisited. Ann Surg 236:82–89CrossRefPubMed
43.
Kahl S, Zimmermann S, Genz I, Glasbrenner B, Pross M, Schulz HU, Mc ND, Schmidt U, Malfertheiner P (2003) Risk factors for failure of endoscopic stenting of biliary strictures in chronic pancreatitis: a prospective follow-up study. Am J Gastroenterol 98(11):2448–2453CrossRefPubMed
44.
Kaman L, Behera A, Singh R, Katariya RN (2001) Internal pancreatic fistulas with pancreatic ascites and pancreatic pleural effusions: recognition and management. ANZ J Surg 71(4):221–225CrossRefPubMed
45.
Klempa I, Spatny M, Menzel J, Baca I, Nustede R, Stoeckmann F, Arnold W (1995) Pankreasfunktion und Lebensqualität nach Pankreaskopfresektion bei der chronischen Pankreatitis. Chirurg 66:350–359PubMed
46.
Kloppel G, Maillet B (1993) Pathology of acute and chronic pancreatitis. Pancreas 8(6):659–670CrossRefPubMed
47.
Kloppel G, Maillet B (1992) The morphological basis for the evolution of acute pancreatitis into chronic pancreatitis. Virchows Arch A Pathol Anat Histopathol 420(1):1–4CrossRefPubMed
48.
Knoefel WT, Eisenberger CF, Strate T, Izbicki JR (2002) Optimizing surgical therapy for chronic pancreatitis. Pancreatology 2:379–385CrossRefPubMed
49.
Koninger J, Seiler CM, Sauerland S, Wente MN, Reidel MA, Muller MW, Friess H, Buchler MW (2008) Duodenum-preserving pancreatic head resection—a randomized controlled trial comparing the original Beger procedure with the Berne modification (ISRCTN No. 50638764). Surgery 143(4):490–498CrossRefPubMed
50.
Kozarek RA, Ball TJ, Patterson DJ, Raltz SL, Traverso LW, Ryan JA, Thirlby RC (1997) Transpapillary stenting for pancreaticocutaneous fistulas. J Gastrointest Surg 1(4):357–361CrossRefPubMed
51.
Kutup A, Vashist Y, Kaifi JT, Yekebas EF, Izbicki JR (2010) For which type of chronic pancreatitis is the "Hamburg procedure" indicated? J Hepatobiliary Pancreat Sci 17(6):758–762CrossRefPubMed
52.
Lankisch PG, Andren-Sandberg A (1993) Standards for the diagnosis of chronic pancreatitis and for the evaluation of treatment. Int J Pancreatol 14:205–212PubMed
53.
Lankisch PG, Happe-Loehr A, Otto J, Creutzfeldt W (1993) Natural course in chronic pancreatitis. Pain, exocrine and endocrine pancreatic insufficiency and prognosis of the disease. Digest 54:148–155CrossRef
54.
55.
Little AG, Moossa AR (1981) Gastrointestinal hemorrhage from left-sided portal hypertension. An unappreciated complication of pancreatitis. Am J Surg 141(1):153–158CrossRefPubMed
56.
Malka D, Hammel P, Levy P, Sauvanet A, Ruszniewski P, Belghiti J, Bernades P (1998) Splenic complications in chronic pancreatitis: prevalence and risk factors in a medical–surgical series of 500 patients. Br J Surg 85(12):1645–1649CrossRefPubMed
57.
Malka D, Hammel P, Sauvanet A, Rufat P, O'Toole D, Bardet P, Belghiti J, Bernades P, Ruszniewski P, Levy P (2000) Risk factors for diabetes mellitus in chronic pancreatitis. Gastroenterology 119:1324–1332CrossRefPubMed
58.
Markowitz JS, Rattner DW, Warshaw AL (1994) Failure of symptomatic relief after pancreaticojejunal decompression for chronic pancreatitis. Strategies for salvage. Arch Surg 129:374–379PubMed
59.
Mayerle J, Lerch MM (2007) Is it necessary to distinguish between alcoholic and nonalcoholic chronic pancreatitis? J Gastroenterol 42(Suppl 17):127–130CrossRefPubMed
60.
Mobius C, Max D, Uhlmann D, Gumpp K, Behrbohm J, Horvath K, Hauss J, Witzigmann H (2007) Five-year follow-up of a prospective non-randomised study comparing duodenum-preserving pancreatic head resection with classic Whipple procedure in the treatment of chronic pancreatitis. Langenbecks Arch Surg 392(3):359–364CrossRefPubMed
61.
Muller MW, Friess H, Martin DJ, Hinz U, Dahmen R, Buchler MW (2008) Long-term follow-up of a randomized clinical trial comparing Beger with pylorus-preserving Whipple procedure for chronic pancreatitis. Br J Surg 95(3):350–356CrossRefPubMed
62.
Nealon WH, Thompson JC (1993) Progressive loss of pancreatic function in chronic pancreatitis is delayed by main pancreatic duct decompression. Ann Surg 217:458–468CrossRefPubMed
63.
Oktedalen O, Nygaard K, Osnes M (1990) Somatostatin in the treatment of pancreatic ascites. Gastroenterology 99(5):1520–1521PubMed
64.
Partington PF, Rochelle REL (1960) Modified Puestow procedure for retrograde drainage of the pancreatic duct. Ann Surg 152:1037–1043CrossRefPubMed
65.
Pessaux P, Kianmanesh R, Regimbeau JM, Sastre B, Delcenserie R, Sielezneff I, Arnaud JP, Sauvanet A (2006) Frey procedure in the treatment of chronic pancreatitis: short-term results. Pancreas 33(4):354–358CrossRefPubMed
66.
Prinz RA, Aranha GV, Greenlee HB (1985) Combined pancreatic duct and upper gastrointestinal and biliary tract drainage in chronic pancreatitis. Arch Surg 120(3):361–366PubMed
67.
68.
69.
Saeger HD, Schwall G, Trede M (1993) Standard Whipple in chronic pancreatitis. In: Beger HG, Buechler M, Malfertheimer P (eds) Standards in pancreatic surgery. Springer, Berlin, pp 385–391
70.
Saps M, Slivka A, Khan S, Meza MP, Goyal A, Di LC (2003) Pancreatic ascites in an infant: lack of symptoms and normal amylase. Dig Dis Sci 48(9):1701–1704CrossRefPubMed
71.
Schnelldorfer T, Lewin DN, Adams DB (2006) Reoperative surgery for chronic pancreatitis: is it safe? World J Surg 30(7):1321–1328CrossRefPubMed
72.
Seelig MH, Chromik AM, Weyhe D, Muller CA, Belyaev O, Mittelkotter U, Tannapfel A, Uhl W (2007) Pancreatic redo procedures: to do or not to do—this is the question. J Gastrointest Surg 11(9):1175–1182CrossRefPubMed
73.
Seelig MH, Janot M, Chromik AM, Herzog T, Belyaev O, Weyhe D, Meurer K, Meiser A, Tannapfel A, Uhl W (2009) Redo-surgery following curative resection of pancreatic carcinoma: the difference between true and suspected recurrence. Dig Surg 26(3):222–228CrossRefPubMed
74.
Soto JA, Barish MA, Yucel EK, Clarke P, Siegenberg D, Chuttani R, Ferrucci JT (1995) Pancreatic duct: MR cholangiopancreatography with a three-dimensional fast spin-echo technique. Radiology 196(2):459–464PubMed
75.
76.
Stenger AM, Knoefel WT, Dahmen U, Blochle C, Izbicki JR (1998) Pancreatico-bronchial fistula with communication to a pseudoaneurysm of the arteria lienalis as a rare complication in chronic pancreatitis. Z Gastroenterol 36(12):1047–1051PubMed
77.
Strate T, Bachmann K, Busch P, Mann O, Schneider C, Bruhn JP, Yekebas E, Kuechler T, Bloechle C, Izbicki JR (2008) Resection vs drainage in treatment of chronic pancreatitis: long-term results of a randomized trial. Gastroenterology 134(5):1406–1411CrossRefPubMed
78.
Strate T, Knoefel WT, Yekebas E, Izbicki JR (2003) Chronic pancreatitis: etiology, pathogenesis, diagnosis, and treatment. Int J Colorectal Dis 18(2):97–106PubMed
79.
Strate T, Taherpour Z, Bloechle C, Mann O, Bruhn JP, Schneider C, Kuechler T, Yekebas E, Izbicki JR (2005) Long-term follow-up of a randomized trial comparing the Beger and Frey procedures for patients suffering from chronic pancreatitis. Ann Surg 241(4):591–598CrossRefPubMed
80.
Strate T, Yekebas E, Knoefel WT, Bloechle C, Izbicki JR (2002) Pathogenesis and the natural course of chronic pancreatitis. Eur J Gastroenterol Hepatol 14:929–934CrossRefPubMed
81.
Traverso LW, Tompkins RK, Urrea PT, Longmire WP Jr (1979) Surgical treatment of chronic pancreatitis. Twenty-two years' experience. Ann Surg 190(3):312–319CrossRefPubMed
82.
Uchiyama T, Yamamoto T, Mizuta E, Suzuki T (1989) Pancreatic ascites—a collected review of 37 cases in Japan. Hepatogastroenterology 36(4):244–248PubMed
83.
Uhl W, Buchler MW, Malfertheiner P, Beger HG, Adler G, Gaus W (1999) A randomised, double blind, multicenter trial of octreotide in moderate to severe acute pancreatitis. Gut 45:97–104CrossRefPubMed
84.
Vijungco JD, Prinz RA (2003) Management of biliary and duodenal complications of chronic pancreatitis. World J Surg 27(11):1258–1270CrossRefPubMed
85.
Warshaw AL (1984) Pain in chronic pancreatitis—patients, patience, and the impatient surgeon. Gastroenterology 86:987–989PubMed
86.
Warshaw AL, Jin GL, Ottinger LW (1987) Recognition and clinical implications of mesenteric and portal vein obstruction in chronic pancreatitis. Arch Surg 122:410–445PubMed
87.
Warshaw AL, Rattner DW (1985) Timing of surgical drainage for pancreatic pseudocyst. Clinical and chemical criteria. Ann Surg 202(6):720–724CrossRefPubMed
88.
Wislooff F, Jakobsen J, Osnes M (1982) Stenosis of the common bile duct in chronic pancreatitis. Br J Surg 69(1):52–54CrossRefPubMed
89.
Yekebas EF, Bogoevski D, Honarpisheh H, Cataldegirmen G, Habermann CR, Seewald S, Link BC, Kaifi JT, Wolfram L, Mann O, Bubenheim M, Izbicki JR (2006) Long-term follow-up in small duct chronic pancreatitis: a plea for extended drainage by "V-shaped excision" of the anterior aspect of the pancreas. Ann Surg 244(6):940–946CrossRefPubMed
Metadaten
Titel
Chronic pancreatitis: modern surgical management
verfasst von
Kai Bachmann
Jakob R. Izbicki
Emre F. Yekebas
Publikationsdatum
01.02.2011
Verlag
Springer-Verlag
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 2/2011
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-010-0732-0

Weitere Artikel der Ausgabe 2/2011

Langenbeck's Archives of Surgery 2/2011 Zur Ausgabe

Case Management & Clinical Consequences

Reconstruction of a total avulsion of the hepatic veins and the suprahepatic inferior vena cava secondary to blunt thoracoabdominal trauma

Original Article

Angioembolization and laparotomy for patients with concomitant pelvic arterial hemorrhage and blunt abdominal trauma

Original Article

Liver tissue sparing resection using a novel planning tool

Original Article

Proximal acid reflux treated by fundoplication predicts a good outcome for chronic cough attributable to gastro-oesophageal reflux disease

How-I-Do-It Article

Transcervical video-assisted thymectomy: preliminary results of a modified surgical approach

Original Article

Oligosymptomatic vs. symptomatic incisional hernias—who benefits from open repair?

Neu im Fachgebiet Chirurgie

17.04.2024 | Postoperative nausea and vomiting | Nachrichten

Hochrisiko-Eingriffe für postoperative Übelkeit

16.04.2024 | HNO-Chirurgie | Nachrichten

HNO-Op. auch mit über 90?

16.04.2024 | Infektiologie | Nachrichten

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

10.04.2024 | Postoperative Schmerztherapie | Nachrichten

Chronische Schmerzen nach Op. oft mit neuropathischer Komponente
weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom CME-Kurs
CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur CME-Kurs
CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis CME-Kurs
CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.